Routine inspection·March 25, 2025

On 03/25/25 at 08:43 AM, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Singh met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staff present, and four (4) residents present. LPA Singh explained the purpose of the visit to staff/care giver Karim Ibarra Morales. Administrator Marquez has been contacted and arrived during the visit. The facility is a five (5) bedroom, two (2) bathroom home with a kitchen/dining area, living room, laundry area and garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which six (6) can be non-ambulatory residents. The facility has two (2) Hospice Waiver. The current census is four (4) residents. LPA was accompanied by Administrator Brandon Marquez-Gutierrez conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPA observed no obstructions to indoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, and storage space, lamps and chairs and sufficient lighting in the bedrooms. Moreover, LPA observed that bathrooms were clean, and appliances were operating appropriately. LPA observed grab bars and non-skid mat in the resident bathrooms. ***Continuation in LIC809C *** LPA observed night-lights maintained in hallways and passages to non private bathrooms. LPA observed the outdoor passageways free of obstructions. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathroom to be at 110 degrees Fahrenheit. The facility is equipped and working with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCLD complaint poster, Ombudsman Poster and the Emergency Disaster plan were posted in a common area. There was a designated storage space for resident/staff files. There is a cabinet with the resident’s medications locked in the medication cabinet. Food Service : Seven (7) days non-perishable and three (3) days perishable food supply observed at the facility. Care & Supervision : LPA observed sufficient number of staff to provide care and supervision to the residents in care and staff scheduled to work at night as required for facility with dementia residents. LPA observed Emergency supplies in one of the cabinets. LPA observed first aid kit and first aid manual at the facility. Record Review : LPA reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings with tuberculosis (TB) test results. LPA observed on-the-job training provided and documented Residential Care for the Elderly (RCFE) and Dementia, Postural Supports, Hospice Care training. LPA Singh observed no issues. LPA singh audited Medication administration Record system (MARS) matched with medication administrated to the residents. LPA observed there were activity program for the residents at the facility. No deficiencies were cited during today's visit. An exit interview was conducted where this report, LIC809, LIC809C were discussed and provided to Administrator Brandon Marquez.